What is Point of Care Ultrasound (POCUS)?

The importance of ultrasound diagnostics should be evident, both for medical practitioners as well as patients who have experienced the process first-hand.

Introduced more broadly in the early 2000s in order to supplement — or in some cases, replace — bulkier and more expensive hospital equipment, Point of Care Ultrasound (POCUS) systems have since become healthcare mainstays.

“A low-cost, pain-free, user-friendly modality, POCUS can be used at the bedside, in the ED, ICU, OR, and in the field. It allows users to quickly diagnose a host of conditions, and it can help with procedural guidance. Its many benefits cannot be denied. No doubt, POCUS is a multi-faceted tool — the Swiss army knife of healthcare — that is in high demand,” wrote Jodi Miller for Diagnostic Imaging.

Comparing Traditional Terms vs. Modern: Bedside Ultrasound vs. POCUS

As miniaturization continues to take place concerning the physical size of POCUS systems, so too does the language surrounding portable ultrasounds as a category.

“Bedside ultrasound” is an older term emerging from a time when a large unit would be moved to a patient’s bedside and then be used by a medical practitioner. By contrast, POCUS systems are highly mobile in nature, and are utilized in a variety of different healthcare settings.

GE Healthcare summarized the timeline as follows:

“By the 1980s, ultrasound technology had improved enough to allow for real-time scanning and image display, making its use more feasible in point of care. However, the 1990s brought dramatic improvements in size, portability, and technology, allowing for ultrasound to be practical for use at the bedside.”

“Since then, POCUS has been instrumental in emergency medicine, trauma surgery, and critical care. Specialists recognized that a portable ultrasound probe allowed them to rapidly assess critically ill patients at the bedside. When the FAST exam was incorporated into advanced trauma life support (ATLS), POCUS was recognized as a standard of care.”

Strengths and Weakness of POCUS

In a 2020 Current Cardiology Reports article, cardiologists Linda Lee and Jeanne M. DeCara outlined the strengths and limitations of POCUS technology, particularly in opposition to a full platform echocardiogram. Some of the strengths of the POCUS platform follow:

Training time: According to Lee and DeCara, training time related to POCUS is both variable and limited, meaning that there’s flexibility in terms of a more abbreviated training period targeting specific medical analyses.

Size and expense: Compared to the full-platform echocardiogram, POCUS technology can be acquired for as little as $2,000. Further, POCUS platforms are ultra-portable and lightweight by design.

Real-time results: POCUS platforms provide instantaneous results which can then be interpreted by qualified healthcare workers.

However, POCUS may be less effective in terms of scanning vented or obese patients; offering 3D Echo doppler, complex doppler — and in some cases spectral doppler — results; and in providing extremely high-resolution imagery.

As POCUS continues to proliferate, improvements are being made on all fronts, from emergency rooms to private practices.

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